胸腰椎爆裂骨折后路椎弓根钉内固定结合病椎骨水泥强化固定的应用

Transpedicular bone cement and posterior pedicle screw fixation in the treatment of thoracolumbar burst fractures

目的：探讨胸腰椎骨折后路椎引根钉内固定结合病椎骨水泥强化固定的临床疗效。方法：对2007-7／2010～10收治的22例胸腰段椎体爆裂骨折采用后路减压内固定结合病椎骨水泥强化固定重建脊拄即刻稳定的临床资料进行总结，通过比较术前、术后第3天进行疼痛视觉类比评分（VAS）判断疼痛改善程度，测量椎体前缘、后缘高度的变化判断椎体高度恢复程度，有元脊髓、神经损伤等并发症。所有结果采用SPSS11．5进行统计分析。结果：22例患者术前、术后第3天的VAS评分明显改善（P〈O．05），手术前后骨折椎体前缘的高度明显增高（P〈0．05）经5～12个月随访，无腰部疼痛，椎管无占位，无继发性后凸畸形发生，内固定元断裂及松动移位等并发症。结论：胸腰椎骨折后路椎弓根钉内固定结合病椎骨水泥强化固定术能很早解决疼痛，实现重建脊柱的即刘稳定性，适合于椎体骨折的脊柱稳定性重建和早期功能恢复。

Objective： To investigate the effect of transpedicular bone cement and posterior pedicle screw itxation m the treatment of thoracolumbar burst fractures. Methods.. From July 2007 to October 2010,22 cases of thoracolumbar vertebral burst fraction without neurological symptoms were treated by distraction reduction fixation system of posterior screw in combination with transpedicle bone cement graft in the department of or- thopaedics. To compare score of visual analog scale（VAS）of pain between the 3^rd day preoperative and postoperative. To make a judgment of recovery of the height of fracture vertebra according to the changes of height of anterior and posterior border of vertebral and complication about spinal and nerve inj ury, All the data were analyzed by the software SPSS 11, 5 statistically, Results： VAS in all eases when preoperative 3 clays was significantly lower than that in all cases when postoperative 3 days（p〈0.05）. Height of anterior border of vertebral increased obviously the 3^rd day postoperative （p〈0.05）. During the 5-12 months follow--up, there are no complications occurred such as lumbago, space--occupying lesions in spinal canal and secondary kyphosis. No looseness or breakage was found in the fixation system. Conclusion： Transpedicolar bone cement and posterior pedicle screw fixation in the treatment of thoracolumbar burst fractures is conducive to rebuiding the stability of the spine,early relief of pain and functional recovery.